Indicators for evaluating European population health: a Delphi selection process

Abstract Background Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeho...

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Main Authors: Ângela Freitas, Paula Santana, Mónica D. Oliveira, Ricardo Almendra, João C. Bana e Costa, Carlos A. Bana e Costa
Format: Article
Language:English
Published: BMC 2018-04-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-018-5463-0
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author Ângela Freitas
Paula Santana
Mónica D. Oliveira
Ricardo Almendra
João C. Bana e Costa
Carlos A. Bana e Costa
author_facet Ângela Freitas
Paula Santana
Mónica D. Oliveira
Ricardo Almendra
João C. Bana e Costa
Carlos A. Bana e Costa
author_sort Ângela Freitas
collection DOAJ
description Abstract Background Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeholders. The aim of this study is to describe the Delphi selection process designed to promote agreement on indicators considered relevant to evaluate population health at the European regional level. Methods Indicators were selected in a Delphi survey conducted using a web-platform designed to implement and monitor participatory processes. It involved a panel of 51 experts and 30 stakeholders from different areas of knowledge and geographies. In three consecutive rounds the panel indicated their level of agreement or disagreement with indicator’s relevance for evaluating population health in Europe. Inferential statistics were applied to draw conclusions on observed level of agreement (Scott’s Pi interrater reliability coefficient) and opinion change (McNemar Chi-square test). Multivariate analysis of variance was conducted to check if the field of expertise influenced the panellist responses (Wilk’s Lambda test). Results The panel participated extensively in the study (overall response rate: 80%). Eighty indicators reached group agreement for selection in the areas of: economic and social environment (12); demographic change (5); lifestyle and health behaviours (8); physical environment (6); built environment (12); healthcare services (11) and health outcomes (26). Higher convergence of group opinion towards agreement on the relevance of indicators was seen for lifestyle and health behaviours, healthcare services, and health outcomes. The panellists’ field of expertise influenced responses: statistically significant differences were found for economic and social environment (p < 0.05 in round 1 and 2), physical environment (p < 0.01 in round 1) and health outcomes (p < 0.01 in round 3). Conclusions The high levels of participation observed in this study, by involving experts and stakeholders and ascertaining their views, underpinned the added value of using a transparent Web-Delphi process to promote agreement on what indicators are relevant to appraise population health.
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spelling doaj.art-80e2ecfd39464ac68adc0e8cf5fc287e2022-12-21T20:26:08ZengBMCBMC Public Health1471-24582018-04-0118112010.1186/s12889-018-5463-0Indicators for evaluating European population health: a Delphi selection processÂngela Freitas0Paula Santana1Mónica D. Oliveira2Ricardo Almendra3João C. Bana e Costa4Carlos A. Bana e Costa5Centre of Studies in Geography and Spatial Planning (CEGOT), University of CoimbraDepartment of Geography and Tourism, Centre of Studies in Geography and Spatial Planning (CEGOT), University of CoimbraCentre for Management Studies of Instituto Superior Técnico (CEG-IST), Universidade de LisboaCentre of Studies in Geography and Spatial Planning (CEGOT), University of CoimbraBana Consulting, LdaCentre for Management Studies of Instituto Superior Técnico (CEG-IST), Universidade de LisboaAbstract Background Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeholders. The aim of this study is to describe the Delphi selection process designed to promote agreement on indicators considered relevant to evaluate population health at the European regional level. Methods Indicators were selected in a Delphi survey conducted using a web-platform designed to implement and monitor participatory processes. It involved a panel of 51 experts and 30 stakeholders from different areas of knowledge and geographies. In three consecutive rounds the panel indicated their level of agreement or disagreement with indicator’s relevance for evaluating population health in Europe. Inferential statistics were applied to draw conclusions on observed level of agreement (Scott’s Pi interrater reliability coefficient) and opinion change (McNemar Chi-square test). Multivariate analysis of variance was conducted to check if the field of expertise influenced the panellist responses (Wilk’s Lambda test). Results The panel participated extensively in the study (overall response rate: 80%). Eighty indicators reached group agreement for selection in the areas of: economic and social environment (12); demographic change (5); lifestyle and health behaviours (8); physical environment (6); built environment (12); healthcare services (11) and health outcomes (26). Higher convergence of group opinion towards agreement on the relevance of indicators was seen for lifestyle and health behaviours, healthcare services, and health outcomes. The panellists’ field of expertise influenced responses: statistically significant differences were found for economic and social environment (p < 0.05 in round 1 and 2), physical environment (p < 0.01 in round 1) and health outcomes (p < 0.01 in round 3). Conclusions The high levels of participation observed in this study, by involving experts and stakeholders and ascertaining their views, underpinned the added value of using a transparent Web-Delphi process to promote agreement on what indicators are relevant to appraise population health.http://link.springer.com/article/10.1186/s12889-018-5463-0Population healthEuropean regionsIndicatorsParticipatory approachWeb DelphiExpert opinion
spellingShingle Ângela Freitas
Paula Santana
Mónica D. Oliveira
Ricardo Almendra
João C. Bana e Costa
Carlos A. Bana e Costa
Indicators for evaluating European population health: a Delphi selection process
BMC Public Health
Population health
European regions
Indicators
Participatory approach
Web Delphi
Expert opinion
title Indicators for evaluating European population health: a Delphi selection process
title_full Indicators for evaluating European population health: a Delphi selection process
title_fullStr Indicators for evaluating European population health: a Delphi selection process
title_full_unstemmed Indicators for evaluating European population health: a Delphi selection process
title_short Indicators for evaluating European population health: a Delphi selection process
title_sort indicators for evaluating european population health a delphi selection process
topic Population health
European regions
Indicators
Participatory approach
Web Delphi
Expert opinion
url http://link.springer.com/article/10.1186/s12889-018-5463-0
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